title: Diabetes mellitus and tuberculosis: pattern of tuberculosis, two-month smear conversion and treatment outcomes in Guangzhou, China.
abstract: OBJECTIVE
  There is a high burden of both diabetes (DM) and tuberculosis (TB) in China. We evaluated the association between DM and the pattern of disease, 2-month sputum smear conversion and treatment outcomes of patients with TB in Guangzhou, China.
  
  
  METHODS
  All patients registered with TB from September 2011 to June 2012 were screened for DM and assessed for treatment outcomes in relation to presence or absence of DM and quality of DM control using patient registers, treatment cards and electronic record systems.
  
  
  RESULTS
  There were 1589 patients with TB of whom 189 (12%) had DM. Among those with DM, there was a significantly higher proportion of men, persons aged 35 years and older and persons with smear-positive pulmonary tuberculosis (PTB) (P < 0.01). In patients with DM and new smear-positive PTB, there was a higher proportion who had positive sputum smears at 2 months (21.7% vs. 5.6%, RR 3.85, 95%CI 2.24-6.63), who were lost-to-follow-up (5.2% vs. 1.7%, RR 3.23, 95%CI 1.08-9.63) and who failed treatment (10.3% vs. 2.3%, RR 4.46, 95%CI 1.96-10.18) compared with patients who had no DM. There was no significant association between these adverse outcomes and DM control as measured by 2 and 6-month fasting blood glucose.
  
  
  CONCLUSIONS
  Diabetes mellitus in new smear-positive patients with PTB was associated with failure to sputum smear convert at 2 months and adverse treatment outcomes of loss-to-follow-up and failure. Further research is needed to understand the reasons for these findings and to determine whether the current length of treatment of 6 months is adequate.
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Fengling
authors.initials: F
authors.lastname: Mi
authors.forename: Shouyong
authors.initials: S
authors.lastname: Tan
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harries
authors.forename: Sven G
authors.initials: SG
authors.lastname: Hinderaker
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.forename: Wentao
authors.initials: W
authors.lastname: Yue
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Bing
authors.initials: B
authors.lastname: Liang
authors.forename: Fang
authors.initials: F
authors.lastname: Gong
authors.forename: Jian
authors.initials: J
authors.lastname: Du
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D005215:Fasting; D005260:Female; D006801:Humans; D015994:Incidence; D059012:Lost to Follow-Up; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D015995:Prevalence; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology*; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D001786:Blood Glucose
keywords: China; diabetes mellitus; treatment outcome; tuberculosis